Patient Satisfaction Survey

It is our vision that Neurosport Physical Therapy provides effective, quality treatments in a high-energy and enjoyable atmosphere. Thank you for taking the time to help us become more effective in providing a positive experience.

Your Age *

Your Sex

Male

Female

How did you hear about Neurosport Physical Therapy?

Was this your first experience with physical therapy?

Yes

No

Was this your first experience with Neurosport?

Yes

No

Please indicate what body part received treatment?

Neurosport location

Your primary therapist’s/athletic trainer’s name (Silverbacks Park)

Your primary therapist’s/athletic trainer’s name (NYC)

Your primary therapist’s/athletic trainer’s name (Alpharetta)

Your primary therapist’s/athletic trainer’s name (Buckhead)

Your primary therapist’s/athletic trainer’s name (East Cobb)

Please rate your degree of satisfaction with each of the following statements.

Respect for your privacy during physical therapy care.

Very Satisfied

Satisfied

Unsatisfied

Very Poor

The courtesy of your physical therapist

Very Satisfied

Satisfied

Unsatisfied

Very Poor

The courtesy of all Neurosport staff members

Very Satisfied

Satisfied

Unsatisfied

Very Poor

Hours of operation

Very Satisfied

Satisfied

Unsatisfied

Very Poor

Able to schedule subsequent physical therapy appointments

Very Satisfied

Satisfied

Unsatisfied

Very Poor

Time you waited before receiving treatment

Very Satisfied

Satisfied

Unsatisfied

Very Poor

The location of Neurosport Physical Therapy

Very Satisfied

Satisfied

Unsatisfied

Very Poor

Your physical therapist’s understanding of your problem/condition

Very Satisfied

Satisfied

Unsatisfied

Very Poor

Explanation of your physical therapy treatment program

Very Satisfied

Satisfied

Unsatisfied

Very Poor

Treatment provided by your physical therapist

Very Satisfied

Satisfied

Unsatisfied

Very Poor

Overall quality of your physical therapy care

Very Satisfied

Satisfied

Unsatisfied

Very Poor

Please rate your response with each of the following statements.

I would recommend this facility to family or friends.

Strongly Agree

Agree

Disagree

Strongly Disagree

I would return to this facility if I required physical therapy.

Strongly Agree

Agree

Disagree

Strongly Disagree

Overall, I was satisfied with my experience with physical therapy.

Strongly Agree

Agree

Disagree

Strongly Disagree

I enjoyed the atmosphere of Neurosport due to: (ex: energy of staff, music, cleanliness).